1. Field of the Invention
The present application relates to an apparatus and method for conducting interstitial laser therapy on tumors, such as breast tumors, and adjunctive therapy on the same treatment table and in the same treatment room. The apparatus employs a combination of a mammography unit, an interstitial laser treatment device which operates with the mammography unit, and a mammography/biopsy chair positioned relative to the mammography unit to enable the interstitial laser therapy and axillary lymph node surgery (sentinel node biopsy) to be performed.
2. Description of the Related Art
Percutaneous in situ or on-site treatment of malignant breast tumors is being developed in part due to the fact that breast cancer is being detected at earlier stages because of the increasing number of women receiving mammograms annually. If breast cancer and other cancers or tumors are detected in an early stage of development, they can be effectively treated by minimal surgery or by using an ablative agent such as laser energy, applied to the tumor for its destruction within the breast.
Mammography is the roentgenography or X-ray of the mammary gland. A mammography unit allows a physician to screen a breast for a tumor. A rotatable/positionable mammography unit with stereotactic capability allows a physician to do even more, i.e., screen a breast for a tumor, locate the tumor and obtain a biopsy of the tumor. Addition of digital technology to mammography assists the physician to process the image better and faster. In other words, a digital mammography unit functions as a screening unit, a diagnostic work-up system and a stereotactic biopsy unit.
The widespread practice of screening mammography and the increasing awareness of women as to its benefits has resulted in a growing number of tumors smaller than one cm being detected. Diagnosis of these non-palpable breast tumors is made by stereotactic or ultrasound-guided core biopsy, a less invasive procedure than wire localization and excisional biopsy. Currently, the favored local treatment of such tumors is by lumpectomy plus either axillary node dissection or sentinel node biopsy followed by chemo-radiation therapy.
Image-guided laser treatments of malignant tumors such as, breast, liver, head and neck tumors, have been in development for more than a decade. For example, U.S. Pat. No. 5,169,396 (Dowlatshahi et al.) is directed to the interstitial application of laser radiation therapy to tumor masses. In general, the apparatus includes a laser probe having a thin metallic cannula for insertion into a tumor mass, a laser for generating light having a chosen wavelength and intensity and an optical fiber for receiving and transmitting the laser light to the tumor mass. In operation, the optical fiber is inserted into the cannula such that a chosen physiologically acceptable fluid can flow coaxially between the cannula and the optical fiber. In addition, a heat sensing member or temperature probe is inserted adjacent into the tumor mass for monitoring the tumor temperature. The devitalized tumor is gradually cleared by the body immune system and within six months is replaced with a scar.
The current known technique for performing interstitial laser therapy for breast tumor includes having the patient lie face down on a platform of a stereotactic table. The patient's breast having the tumor extends through an aperture defined by the platform. The table supports a mechanism positioned below the platform for performing the interstitial laser therapy with the laser probe and in one embodiment a temperature probe.
One problem with such stereotactic tables is that some patients' breast are too small to extend fully to the necessary position adjacent to the mechanism for performing the interstitial laser therapy with the laser probe and temperature probe.
Other problems with stereotactic tables used for performing interstitial laser therapy for breast tumor are (1) the operator (surgeon) must work below or under the table in a cramped space and (2) axillary lymph node surgery cannot be done in that position. In other words, the patient has to be moved from the stereotactic table and transferred to a more appropriate treatment table, usually located in another treatment room, for any adjuvant operation.
In operations and many other procedures, including adjunctive therapies, where blood loss is possible, a patient must be placed on a suitable operating table or the like which has an inverted head position. One such adjunctive therapy procedure related to interstitial laser therapy for treating breast tumors includes the removal of one or more of the patient's lymph nodes. In the event that the patient's blood pressure drops during the procedure, a doctor can place the patient in an inverted head position to direct more blood to the patient's head to avoid any period of time where an insufficient amount of blood is being provided to the patient's brain. An insufficient amount of blood to a patient's brain can, of course, result in brain damage or death.
Additionally, stereotactic tables are relatively expensive. Accordingly, there is a need for a relatively inexpensive apparatus and method for conducting interstitial laser therapy and adjunctive therapies in the same treatment room without requiring the patient to move to a different platform or a different treatment room.